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I sat quietly surveying my field of vision like a pilot of a battle tank. And I realized that I was looking at a killing field. It mostly happened last night, but it was veiled in the darkness. I had no idea that it was this vicious, until I saw it in the morning light.

In front of my eyes lay several casualties. Perhaps in the hundreds. They were all dead. Crushed and mangled. Their innards scattered on the battle field.

Life is short. I know for them it is shorter. And it just become even shorter. Life can be unfair sometimes.

All they want is freedom. Freedom to live. Freedom to propagate. Freedom to roam on a beautiful warm summer’s night.

But I want my freedom too. And my freedom to roam clashed with theirs.

I don’t like it. Nor did I plan it. It was not my intention to annihilate them. No, not at all! They were just in the wrong place, and in the wrong time. Or was it me that was in the wrong place and in the wrong time?

Few weeks ago, my family visited a 90-acre field of wild flowers. It was actually a farm land before, but the owners turned it into a natural prairie. Here in Iowa, the state gives incentives through federal conservation program wherein the government will give yearly rental payment in exchange of farmers turning their agricultural land into a prairie or a wooded area. This is one way of reclaiming industrial lands into natural habitats for the wild life.

Wanting to see more beautiful field of flowers, my wife checked on a website and learned that there is a lavender farm here in Iowa. She envisioned that it will be an expansive gorgeous fields of lavender flowers. Besides, the farm is located near a scenic route, the Loess Hills, which is included in the National Scenic Byways of America, meaning it is a must-see drive. Since we have not seen it yet, so we drove to it last weekend.

The lavender field is about two hours drive away from our place. Here in the United States’ midwest, two hours drive is nothing. At least when we say two hours drive, we mean we’re really driving mostly at maximum speed limit. Unlike in other parts of the world, like in Manila, two hours drive means a distance you can get to in twenty minutes but you’re stuck in traffic for two hours.

After finishing our Sunday morning chores, we packed the family in the car and drove. My college-age daughter, who is home for the summer, was not even feeling well that morning due to menstrual cramps, but we drag her anyway so she won’t miss it. She just brought a pillow and laid down in the backseat.

It was a relatively cool day for a summer, as it was cloudy and even had intermittent showers. In fact we encountered some heavy rains along the way, which to me, just made the trip more interesting.

As we approached our destination, we passed by an overlook area. It has a tower where you can view the surrounding scenery. My daughter was feeling better already at that time, that she got off the car and also climbed the tower.

When we came to a nearby town just minutes to our destination, we decided to stop for lunch first before heading to the place. We discovered a nice old diner. It has a 1960’s theme, or perhaps they just did not change it since they opened. We found out that this diner was a major hub even back in the days, as it was near a major train station.

When we continued on our trip, we got lost as our GPS directed us not to the exact site. Yes, I gave the verdict that the GPS was at fault, and it cannot defend itself. We phoned the farm’s number and it re-directed us to its location.

Finally we found the place. As we were pulling into their parking lot, we saw the field in front of us and it was nothing like what we imagined or expected. It was a dud. A let-down. A disappointment.

No stretches of beautiful lavender. No expansive field of wonderful flowers. Instead, it was a patch of drying bushes. In its defense, perhaps we were just expecting too much.

As we already drove for two hours, so we still went down and checked the farm, including the small shop they have in that place. We did not tarry though.

We then decided to drive further in a road that has a sign “National Scenic Byway.” It was said that this scenic byway, the Loess Hills, has a unique terrain, formed by windblown silt, called loess. No other place in the world except the one in China, where there are higher loess hills formation than this place in Iowa.

After driving for some time in this said scenic byway, we admit that they were interesting, but we’re not utterly impressed. Maybe because we have already driven from US coast to coast, and we have seen more stunning scenic byways. We turned around and headed for home.

We passed by a small town that has a number of antique shops on our way home. The last time we were there was more than 10 years ago (see previous post). My son who was less than 3 years old at that time, accidentally knocked down an antique mirror sitting on a floor at one of the stores. The mirror fell on its face and shattered the glass into several pieces. I ended up paying $200 dollars. Since I paid for it, I took home the wood or board where the mirror was mounted. $200 for a piece of board!

They say that breaking a mirror will cause seven years of misfortune. I don’t think so. What followed was several years of bliss living in Iowa.

This time we did not shatter any mirrors. Just shattered expectations, I guess. After that last stop, we came home after almost 6 hours on the road.

Have you had any similar experience? Going to a place that did not live up to your expectations? Did we just wasted a day and some gallons of gas? I don’t want to believe so. For even if the destination was less than spectacular, we still spent some quality family time together.

Life is a journey. Sometimes it is not the destination that matters. But it is the joy of experience, discovery, shared moments together, and the eventual precious memories during the travel, that really matters.

It is my third time to visit Boston. This time I came to Boston to catch up on sleep.

No, I’m not saying that Boston is a sleeper city, for it is an exciting place to visit. Nor am I’m saying that it is a place most conducive for sleeping. In fact since we stayed in a hotel in the heart of the city, it was quite noisy, with all the cars honking and with loud police and ambulance sirens wailing. Added to that, we landed past midnight in Boston, contributing to my sleepy predicament.

Why I came to Boston is to attend a conference to catch up with the current studies, trends and technology in the practice of Sleep Medicine. Honestly I nap a little in some of the lectures, so I literally catch up on my sleep too!

theme poster of the convention

The science behind sleep has fascinated me since I was in high school, so it’s not a surprise that one of the subspecialty I pursued was on this field.

One of the fascinating sleep phenomenon that I wanted to learn more of are the Parasomias, which includes nightmares, night terrors, sleep walking, and more that goes bump in the night.

One Parasomnia is REM Behavior Disorder (RBD), in which people with this disorder reenact their dreams. Normally when we are in REM (Rapid Eye Movement) stage, a sleep stage when dreams usually occur, our muscles are disengaged and we are temporarily paralyzed, so we don’t move and act out our dreams. In people with RBD, for some reasons the muscles are not paralyzed, so they can kick, swing a punch, crawl out of bed, or even perform a complex activity while sleeping. Not only this put the patient in danger, but also the sleep partner.

One interesting fact I heard from one lecturer is that soursop which is a tropical fruit, or also known as guyabano in my home country, the Philippines, can potentially increase the incidence of RBD. I can almost read a headline news: sleeping wife punch husband, after drinking guyabano punch.

opening session

Besides the medical implications, there’s also societal implications of people having poor sleep. These are also topics discussed during the convention.

Research have shown that birds can sleep, as half of their brain can go to sleep, while on long flights. But not humans. We need all our faculties when we are doing complex task like flying a plane. Though aviator Charles Lindbergh, the first man to cross the Atlantic on solo flight was awake for more than 34 hours when he accomplished that feat, nowadays we have instituted regulations for pilots limiting their hours of flying and assuring they have a sufficient amount of sleep in between flight.

Same principle applies with operating any machinery or driving any motorized vehicle. Studies have shown that a significant number of vehicular accidents are due to driver fatigue and sleepiness. For instance a sleepy driver can have a slower reaction time. A decrease of even 50 milliseconds in reaction time in hitting the brakes means 5 feet more before coming to a stop, and that can mean safely stopping or crashing, or escaping an accident or dying.

For the medical community, especially the ones who are undergoing residency training, there’s now an imposed 16 hour limit for a first year resident for continuous work. Beyond that they should be relieved, for they need to go to sleep. During my residency training in the mid 90’s, the limit for continuous hospital duty was 30 hours. This regulations though are not enforced to doctors after they are done with their training.

We as a community really need to change our opinions. Staying awake all night to study or pulling an all-nighter to finish the job has become a badge of honor. We view sleep as only for slackers. When we should view that those people who get adequate sleep, that is 7-8 hours a night, should be the ones commended. So no more sleepless in Seattle, or Boston, or New York, or Tokyo, or any part of the world for that matter.

Just like when you’re hungry, the solution is to eat. For people who are sleepy the solution is not more coffee or energy drink, but getting adequate amount of sleep. Of course if you have a sleep disorder and not getting a restful sleep then you need to see your doctor.

Sleep is important in so many levels. Not only for health but also for safety and being more productive. In addition, dreams come when we sleep, and life without dreams would be uninspiring.

Since I live in the outskirt of the city of greater Des Moines, I travel some distance everyday for work. I drive close to 40 miles a day roundtrip. I don’t mind to drive though, as long as the traffic is moving fast. In reality it only takes me less than 25 minutes one way, which is less than the average time Americans spent going to their workplace. I know if I drive in Metro Manila, that distance I covered will take me an hour or two, plus a lot of cursing.

In addition, as I have written in the past, I go once a month to our satellite clinics (I go to 2 outreach clinics now) which is about an hour and a half drive from our main office. Even though it is about 80 miles away, the travel is easy with open highways that goes through scenic rural Iowa of rolling hills of farmlands and prairies. In fact I even consider the drive relaxing (read previous post “Zen Driving”).

For the past several years I have made this journey alone, except for my thoughts, the radio playing the music I picked for that day, and my trusted car. The other day, I made that same journey again. But somehow, something was different.

It was my last drive on this trip with my “old” car.

My car is getting old. Like dogs, 1 car year is probably comparable to 7 human years, especially if you drive it a lot. I have read in car reviews that the average life span of a car is about 10 – 13 years or about 150,000 miles. Though there are cars that still runs good even after 200,000 miles.

My car is 10 years old and approaching 150,000 miles. It may be considered already a grandma in car years, though it still runs well, however it’s getting expensive to maintain. Not too long ago, I have to change some parts that costs a hefty sum, that I wondered if its worth spending that amount. I surely would not like to spend more than its remaining trade value.

Thus I decided that its time for it to go.

But on our last trip together, I let it run wild. Instead of zen driving I transitioned to rallye driving. I shifted to sports gear all the way, and I let its engine revved as we climb hills and raced through open highways, bringing out its racing heritage. My car may be old, yet it still has lots of feistiness remaining in it.

As we were whizzing through open country roads and as I was listening to its engine growl, my car was singing to me its swan song.

I was scooting from one patient’s room to another in our clinic the other day as it was a busy day for me. Our schedule was full and our clinic was busting at the seams with patients. I think that’s good. Not good that many people are sick, but good in the sense of job security.

Then in one stretch of time in the afternoon, I saw three nonagenarians (person in their 90’s) back to back, to back. They were there for asthma follow-up and regular check-up.

Two patients were both 94-year-old ladies, and one patient was a gentleman who was 93. If you don’t look at their records and peek at their birth dates, you would think they were much younger. Decades younger.

All of them were in remarkable shape despite their advanced age. They will put to shame some of my 40 or 50-year-old patients.

All of them still live independently. All of them were spry and sharp, and were still quite active. And all of them still drive. Not drive their family crazy. But they still drive a car! In my opinion, there’s no reason why they cannot.

I know that driving nowadays is getting easier and easier. With most of our cars with automatic transmission, it does not take a lot of skill to drive a car. And now with our advancing technology, there are “smart” cars that will automatically stop and avoid collision, or keep you in lane, or adjust your distance to the cars in front of you, or warn you of your blind spot, or cars that even park itself.

I know not very long from now, we will have self-driving cars, which are already being tested, cruising in all our highways. Then driving ability and skill will not even be necessary.

But still having a very old person at the back of a steering wheel can be a scary thought. If you think about a frail 90-year-old lady with failing eyesight, very poor reflexes and perhaps lapsing memory too, barreling down the road in a big Buick, and you’re in the crossroad, and you wonder if old grandma will be oriented enough to release her foot off the gas and step on the brake. Will she be able to stop in time not to run you over?

(picture from classbrain.com)

Back to my patients, out of curiosity I asked one of my 94-year-old lady patient what kind of car she drives. A vintage automobile perhaps?

She told me proudly that she drives a bright yellow, German-made, convertible with an accompanying vanity plate. I bet you with a car like that she does not drive slow like a grandma.

Great grandma was still driving in style!

When I came to examine the other 94-year-old lady, I was more than curious to ask what car she drives. As a jest I asked her if she also drives a convertible? Her answer blew me away.

She told me that she used to drive a convertible until 2 years ago, but traded it for a more subdued style of car. She does not care about convertible anymore as it just messes her hair.

Yet she said that she cannot give up though the type of car that she was used to drive, all these years. So even though it was not a convertible, it was still this kind. What kind?

Thanksgiving time is hands down the busiest time of travel here in the United States.

It is estimated that there will be about 24 million people scuffling through the airports during the Thanksgiving season. If you think that is an impressive number already, that is only a very small portion of all travelers, as 90% will be traveling by car. And more than 50% of these road warriors will travel more than 100 miles.

If you are driving for long distances, you must be thankful for rest stops along the way, where you can pull over and stretch your legs, or take a toilet break, or even catch a few winks before you continue on the long road ahead. We have done long drives before and we appreciate the value of a rest area.

Iowa, where I reside now, is smack in the middle of America, and the house where I live is just 2 miles from I-80, which is a major road artery that connects the east and west of America. Interspersed along I-80 are some of the biggest and nicest rest areas you can find.

Though some friends of ours, who travelled from California to Toronto, or Michigan to California, or even shorter drive from Indiana to Colorado, and were passing through I-80, have stopped over our home for a break and a visit. Of course we did not charge them for bed and breakfast.

Yesterday morning, I learned that our place was some other form of rest stop as well. For the birds.

I was out on my Sunday morning run, and as I approach a pond, I heard a ruckus. Lots of trumpeting and flapping. When I looked up there were flocks of geese circling above me.

They were taxiing for a landing.

I realized that this season, with the winter approaching, is also a busy time of travel for the migratory birds, as they fly to warmer places. These birds travel from few hundred miles to several thousand miles depending on the species. Some will fly a few thousand miles non-stop until they reach their destination. While some will have some rest stop along the way.

Obviously these flocks of geese were stopping over in our place. Maybe it was for a quick bite and bathroom break. Maybe it was to cool their wings. Or maybe it was for a relaxing swim in the pond. Whatever it is, I believe it was due to our excellent accommodation. And we don’t charge them!

Below is a short video clip of this rest stop.

If only turkeys can travel and migrate too during this season. They would be flying (or running) away to some safer place. That is away from our dinner table. Yet the only rest stop they will end up this Thanksgiving is inside our belly. Aren’t you thankful you’re not a turkey?

In any case, wherever you are traveling to this holiday season, or wherever your final destination in your journey in this life, may you have a safe trip.

They said it is a landmark event. An occasion of historic proportion. Signaling the dawn of a new era.

Before you get too excited, perhaps I’m just getting overly dramatic. It just that it was the first time that I was sitting on the passenger seat of a car, and my daughter was on the driver’s seat. My little girl is driving!

My daughter who is now 16 years of age, has recently acquired a learner’s permit and can drive under adult supervision. She is also taking a driver’s education course (driver’s ed).

Completing a formal driver’s ed, is required here in Iowa for all who have learner’s permit before they can apply for a full driver’s license. This includes 30 hours of classroom instruction and 6 hours of laboratory instruction, including 3 hours behind the wheel. That’s an extensive driving lesson, more than all the driving tips I can provide. Plus I don’t want her to inherit my bad driving habits that I learned from driving in Manila.

In the meantime, this means my daughter can drive as long as an adult with a valid driver’s license, is with her inside the vehicle. In another year, she’ll be able to drive alone on her own altogether.

This is exciting because this means my daughter is now a young lady and driving must be a monumental experience for her. Isn’t it not too long ago that she was just sitting at the back, strapped on a child car seat, and kicking the back of my driver’s seat?

Yes exciting, but also scary.

Scary not because I’m afraid that she’ll drive recklessly and crash. She’s more “law-abiding” than any of us in the family. If the speed limit says 55 miles per hour, she will stay at 55. Not 65. Not 60. Not 58. But 55!

Scary not because I don’t trust her with this big responsibility signifying her independence. For I do trust her and I know that she is a responsible young lady.

It is scary because this means that as much as I want to be in control and protect her all the time, this time she has to do it on her own.

A couple of days ago, I let my daughter drive with all of us inside the car. I sat on the front passenger seat, while my wife and son were in the back seat. Not too long after we pulled out of our driveway, I got so tense and almost jump from my seat, as I thought she was driving too close to the curb and almost hit our neighbor’s mailbox.

After giving her more driving tips, I tried to relax, but I can’t. My feet every now and then, would unknowingly kick or step on the floor as if I have the gas pedal or brake pedal on my side. I remember my father doing this too when he let me drive for the first time. It is a parent’s reflex.

Many times as parents, due to our paternal or maternal instincts, we always have the feeling that our children are in harm’s way and we try to protect them and keep them always under our wings.

But there comes a time, that we should let go. And let them take flight.

After a few more miles, as my daughter have gained more confidence behind the wheel, without me overbearing on her every move, I was able to control my anxiety and settle down. I am not the driver anymore. I am now a mere passenger.

Several more minutes later, we arrived at our destination safely and with my sanity intact. I’m sure my wife was much relieved too. Though I would say, my daughter still need to work on her parking skills.

Maybe someday when she will be more masterful in her driving, I can sit in the back of the driver’s seat. And as an homage and payback, I’ll softly kick her seat.

******

Post Note: After publishing this piece, I received a notification that this is my 500th post. This is another landmark! Again, thank you for all you readers who make this all worthwhile.

During my last visit to the Philippines, I have to be re-oriented to the pervading traffic rules in Metro Manila. Since I grew up in Manila, I really thought these rules are the norm for all drivers around the world, but I have to unlearn them when I started driving in the United States.

This is a primer for tourists visiting the Philippines, or long-gone expats, and for all the uninitiated. As our latest tourism campaign goes: it’s more fun in the Philippines.

1. When approaching an intersection with traffic light: green means go; yellow means go faster; red means it is optional to stop if there’s a policeman patrolling nearby, otherwise you can still go at your own risk.

2. The painted lines to mark the lanes on the road are just for decorative purposes to make the road look nicer, for they don’t have any other purpose at all; you can swerve in between lanes as much as you want, and even into the opposing traffic lane.

3. When driving, put your one hand at the steering wheel, while the other hand on the horn; it is expected that you blow your horn every 5 seconds or even more frequent than that; it is a common courtesy that if somebody blows their horn on you, that you answer them back or blow your horn louder and longer.

4. When approaching a 4-way stop or any open intersection without traffic light, the rule is that the most faint of heart will need to stop first. No need to slow down, and just let the other drivers with less courage slam on their brakes.

5. Seatbelts are for sissy. These safety belts hanging on the sides of the vehicles are there for ornamental function only. Do not touch them nor fasten them around you, or else they will know that you’re a tourist or a visitor.

6. In case a policeman stopped you for a “traffic violation” and asked for your driver’s license, they don’t mean the card with your photo, but a piece of paper with a Philippine hero’s image on it, or also known as money. The higher the currency, the faster you will be let go.

7. Expect to be stuck in traffic for hours; so bring a snack, a book to read, or even a urinal. If you are really in a hurry but don’t mind to sweat, walk instead; it will take you 2 hours to drive during rush hour a distance you can walk in 30 minutes.

8. Pedestrians have the right of way at all times not just on pedestrian lanes or crossing lanes; they can cross anytime and anywhere they want. They can even play “patintero” (a popular Filipino children’s game) with the rushing vehicles. Watch out for pedicabs and bicycles too for they can go anywhere (and make “singit”) even against the flow of traffic on the opposite lanes.

9. Public utility vehicles (jeepneys, FX, buses, taxis, and tricycles) are the kings of the road, they can stop in the middle of the road to let their passengers alight or pick-up more passengers, so beware. Of course there are loading and unloading zones for passengers, but nobody really care about those zones.

10. When you are on the road, whether you are stuck in traffic, or exasperated with the other drivers, just remember to always keep your sense of humor. Driving in the Philippines should be treated as a comedy, though in reality it is a tragedy.

As I was pulling out of my driveway this morning, the news on my car radio reported that according to a survey, the Midwest drivers are the safest drivers in the United States. That was reassuring to know that my every day drive is relatively free of danger and I am with the company of best drivers.

I also read before that in a study by one insurance company, Des Moines was one of the cities with the safest drivers. Interestingly, New Jersey, a place where we lived before, had the worst drivers according to one poll a couple of years ago.

I do not think New Jersey was that terrible, at least when we were there. I thought New Yorkers were worse drivers, based upon my experience when we lived there. They honk their horn for no good reason, they cut you off, and they are not courteous at all (unless you consider the “finger” salute as a sign of respect!).

The New York taxi drivers are of a different breed. I know there are some exceptions, but overall they are pretty bad. There was one instance when I rode a taxi cab from the JFK airport to our apartment in Manhattan, that I had more heart-stopping excitement riding in that cab than when I rode a roller coaster with triple loops at Universal. It was that horrible.

We also lived in Los Angeles briefly, and drove in its roads for a time. The freeway traffic ranges from fast and furious to snail-pace stop and go depending on the time of day. I think its not so bad, if you can dodge the bullets from the deranged drive-by shooters.

Then when we lived in Florida, I also experienced driving in retirement communities. It can be frustrating when you get stucked behind a very slow moving car, only to find the driver to be a frail old lady that you think can barely see, let alone drive. At least she was not texting and had her two hands tightly gripping the steering wheel.

But nothing compare to Manila drivers. Traffic rules? What traffic rules? Traffic lights and stop signs are optional, and it’s to the discretion of the driver to follow it or not. Or it depends if there’s a policeman hiding behind the light post accross the intersection. The bus drivers, jeepney drivers and taxi drivers are better than the priests in making people embrace religion. For they make their passengers piously pray when they are driving!

So back to my current residence here in Iowa. I was driving along the interstate today, when I saw a woman driving with one hand holding a phone to her ear, and then puffing a cigarrette with the other hand, leaving both hands off the wheel for a couple of seconds. Or maybe she have a third hand?

But I have seen other dangerous driving behavior here in the supposed to be “safe drivers” zone: people texting, applying make-up while driving at full speed, eating with one hand on the burger and the other hand with the drink, and reading a book, with a book resting on the steering wheel.

As I continued my drive, a minivan overtook me at speed way above the speed limit. The van had a dead deer strapped in its roof, with its fur and tail flapping in the wind. It is common to see extra luggages, or bikes, or canoe, or Chirstmas tree (on holidays) strapped on the roof, but a dead deer? And even though Iowa is big on hunting, that was the first time I saw a deer strapped on the roof, except in movies. I also noticed that the van had one window broken, and was stacked-up to the ceiling full of junk. I don’t think the driver can see through his rearview mirror with all those junk.

As I was exiting the freeway, a big black SUV with dark tinted windows swerved in front of me without signalling and cut me off, making me hit the brakes. I was tempted to honk my horn and give him the finger salute, but it could be the secret service. And besides, these are the safest drivers after all. Frightening thought.